The Nicaraguan Pesticide Poisoning Register: constant underreporting

Area of Science:

• Environmental Health
• Public Health
• Epidemiology

Background:

• Acute pesticide poisonings (APP) pose a significant public health concern.
• Existing pesticide surveillance systems may not capture the full extent of APP.
• Accurate data is essential for effective policymaking and resource allocation.

Purpose of the Study:

• To estimate the level of underreporting of APP in Nicaragua's national pesticide surveillance system in 2000.
• To assess the economic burden of APP on affected individuals.
• To highlight the need for improvements in pesticide data collection and reporting.

Main Methods:

• A nationally representative cross-sectional survey of 3,169 individuals aged 15 years and older was conducted.
• Data on pesticide exposure, health effects, and medical treatment sought were collected.
• Reported cases in the official register were compared with survey findings.

Main Results:

• The official register reported 1,369 APP cases, while the survey identified 22 cases seeking medical attention.
• Only one of these 22 cases (less than 5%) was reported in the national register.
• The average out-of-pocket treatment cost was $41, equivalent to nearly one month's salary.

Conclusions:

• Nicaragua's pesticide surveillance system significantly underreports APP, potentially missing approximately 30,000 cases annually.
• Underreporting hinders accurate assessment of APP's health impact and effective policy development.
• Enhancing surveillance routines, training, and private provider participation is vital for improving data accuracy.